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In 4 of 17 Helicobacter pylori strains obtained from antral biopsy samples, the registered primary resistance (MIC, &gt; 32 microgram/ml) appeared to be nonstable after prolonged microaerophilic incubation. In all resistant strains tested, susceptibility could be obtained when culture under normal microaerophilic conditions was preceded by a period of anaerobic incubation. Both of these findings may explain the observed discrepancy between the results of in vitro susceptibility tests and the eradication obtained in vivo.

antimicrobial agents and chemotherapy

Explanations for high rates of eradication with triple therapy using metronidazole in patients harboring metronidazole-resistant Helicobacter pylori strains